Research Article

Management of Popliteal Artery aneurysms: Experience in our center

Michiels Thirsa and Vleeschauwer De Philippe*

Published: 25 January, 2018 | Volume 2 - Issue 1 | Pages: 001-009

Background: Popliteal artery aneurysms (PAAs) are rare, but the diagnosis should not be missed because of the limb and life threatening complications. The purpose of this study was to reach a consensus about the management of PAA based on our own experience and the available literature.

Materials and Methods: This is a retrospective analysis of all patients who underwent an open surgical PAA repair at our institution from January 2015 to December 2016. Demographic data, risk factors, clinical presentation, aneurysm characteristics, type of repair and results were reviewed. Results include patency and major complications.

Results: Seven patients underwent an open surgical PAA repair (six men). Median age was 72 years. A posterior approach (PA) was chosen four times and a medial approach (MA) was chosen three times. We performed six resections with interposition of a graft and only one ligation with a bypass. Five patients recovered well, did not develop any complication and did not need a second intervention to guarantee patency. These patients underwent a resection of the aneurysm and interposition of a graft (four via a PA and one via a MA). One patient treated by resection and interposition of a Dacron graft via a MA underwent an above-the-knee amputation at postoperative day 14. This patient had a preoperatively dysfunctional leg since several months with no patent outflow vessels. Our patient treated by ligation and bypass via a MA, developed an acute ischemia four months postoperatively because of an extreme flexion of the knee during several hours while watching TV. After unsuccessful trombolysis, he underwent a femorotibial bypass and a partial forefoot amputation. No long-term results are yet available.

Conclusions: In our opinion, open surgical repair of PAAs by resection of the aneurysm and interposition of a venous graft has the best results. Depending on the relation to the knee joint and thus the accessibility of the aneurysm, a posterior approach is preferred. We are not convinced of endovascular techniques in the treatment of popliteal artery aneurysms

Read Full Article HTML DOI: 10.29328/journal.avm.1001003 Cite this Article Read Full Article PDF


Popliteal artery aneurysm; Posterior approach; Open surgical repair


  1. Pittathankal A, Dattani R, Magee T, Galland R. Expansion Rates of Asymptomatic Popliteal Artery Aneurysms. Eur J Vasc Endovasc Surg. 2004; 27: 382-384. Ref.: https://goo.gl/DnDAvb
  2. Galland R. Popliteal Aneurysms: From John Hunter to the 21st Century. Ann R Coll Surg Engl. 2007; 89: 466-471. Ref.: https://goo.gl/4vdCYe
  3. Szilagyi DE, Schwartz RL, Reddy DJ. Popliteal Arterial Aneurysms. Arch Surg. 1981; 116: 724. Ref.: https://goo.gl/oQkzXi 
  4. Anton G, Hertzer N, Beven E, O'Hara P, Krajewski L. Surgical management of popliteal aneurysms. J Vasc Surg. 1986; 3: 125-134. Ref.: https://goo.gl/XTdjYL
  5. Carpenter J, Barker C, Roberts B, Berkowitz H, Lusk E, et al. Popliteal artery aneurysms: Current management and outcome. J Vasc Surg. 1994; 19: 65-73. Ref.: https://goo.gl/oVDSQq
  6. Michaels J, Galland R. Management of asymptomatic popliteal aneurysms: The use of a markov decision tree to determine the criteria for a conservative approach. Eur J Vasc Surg. 1993; 7: 136-143. Ref.: https://goo.gl/tJfUUP
  7. Claridge M, Hobbs S, Quick C, Adam D, Bradbury A, et al. Screening for popliteal aneurysms should not be a routine part of a community-based aneurysm screening program. Vasc Health Risk Manag. 2006; 2: 189-191. Ref.: https://goo.gl/yjBif8
  8. Bowyer R, Cawthorn S, Walker W, Giddings A. Conservative management of asymptomatic popliteal aneurysm. Bri J Surg. 1990; 77: 1132-1135. Ref.: https://goo.gl/4mRzq2 
  9. Neiman H, Yao J, Silver T. Gray-Scale Ultrasound Diagnosis of Peripheral Arterial Aneurysms. Radiology. 1979; 130: 413-416. Ref.: https://goo.gl/xzm3k1
  10. Rizzo R, Flinn W, Yao J, McCarthy W, Vogelzang R, et al. Computed tomography for evaluation of arterial disease in the popliteal fossa. J Vascu Surg. 1990; 11: 112-119. Ref.: https://goo.gl/1XvQRL
  11. Schellack J. Nonoperative Management of Selected Popliteal Aneurysms. Archives of Surgery. 1987; 122: 372-375. Ref.: https://goo.gl/qS9HD2
  12. Lowell R, Gloviczki P, Hallett J, Naessens J, Maus T, et al. Popliteal Artery Aneurysms: The Risk of Nonoperative Management. Ann Vasc Surg. 1994; 8: 14-23. Ref.: https://goo.gl/N2moXQ
  13. Shortell C, DeWeese J, Ouriel K, Green R. Popliteal artery aneurysms: A 25year surgical experience. J Vasc Surg. 1991; 14: 771-779. Ref.: https://goo.gl/o7XTTk
  14. Mahmood A, Salaman R, Sintler M, Smith S, Simms M, et al. Surgery of popliteal artery aneurysms: A 12-year experience. J Vasc Surg. 2003; 37: 586-593. Ref.: https://goo.gl/N5dGYU
  15. Dawson I, Sie R, van Bockel J. Atherosclerotic popliteal aneurysm. Bri J Surg. 1997; 84: 293-299. Ref.: https://goo.gl/CQqBFo  
  16. Aulivola B, Hamdan A, Hile C, Sheahan M, Skillman J, et al. Popliteal artery aneurysms: a comparison of outcomes in elective versus emergent repair. Journal of Vascular Surgery. 2004; 39: 1171-1177. Ref.: https://goo.gl/4WhPMi
  17. Cervin A, Tjärnström J, Ravn H, Acosta S, Hultgren R, et al. Treatment of Popliteal Aneurysm by Open and Endovascular Surgery: A Contemporary Study of 592 Procedures in Sweden. Eur J Vasc Endovasc Surg. 2015; 50: 342-350. Ref.: https://goo.gl/Jz6ujV
  18. Mazzaccaro D, Carmo M, Dallatana R, Settembrini A, Barbetta I, et al. Comparison of posterior and medial approaches for popliteal artery aneurysms. J Vasc Surg. 2015; 62: 1512-1520. Ref.: https://goo.gl/aDVS5F
  19. Ravn H, Wanhainen A, Björck M. Surgical technique and long-term results after popliteal artery aneurysm repair: Results from 717 legs. J Vasc Surg. 2007; 46: 236-243. Ref.: https://goo.gl/JrnAwt
  20. Antonello M, Frigatti P, Battocchio P. Open Repair versus Endovascular Treatment for Asymptomatic Popliteal Artery Aneurysm: Results of a Prospective Randomized Study. J Vasc Surg. 2005; 42: 185-193. Ref.: https://goo.gl/Qb1tEc
  21. Tielliu I, Verhoeven E, Zeebregts C. Endovascular Treatment of Popliteal Artery Aneurysms: Results of a Prospective Cohort Study. J Vasc Surg. 2005; 41: 561-566. Ref.: https://goo.gl/t1HREB
  22. Pulli R, Dorigo W, Castelli P, Dorrucci V, Ferilli F, et al. A Multicentric Experience with Open Surgical Repair and Endovascular Exclusion of Popliteal Artery Aneurysms. Eur J Vasc Endovasc Surg. 2013; 45: 357-363. Ref.: https://goo.gl/xjJ3bJ
  23. Von Stumm M, Teufelsbauer H, Reichenspurner H, Debus E. Two Decades of Endovascular Repair of Popliteal Artery Aneurysm-A Meta-analysis. Eur J Vasc Endovasc Surg. 2015; 50: 351-359. Ref.: https://goo.gl/KGMnNk


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